Grief Meets grief meets grief meets grief

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In some grief work one year is offered as an arbitrary timeframe for the most intense feelings of grief. It isn’t true for everyone, of course, and “it depends” is the only real answer to the question of how long the intense part of grief lasts.

There are so many factors that affect the grief process that they would make this blog post unwieldy and confusing so I’m only going to talk about a few of them.

Multiple Losses

Research shows that multiple losses close together makes it more difficult and complicated to grieve (Mercer & Evans, 2006). Some grief theorists would prefer that people grieve one loss at a time before moving on to the next one. And of course, grief theorists and clinicians realize that is impossible. When there are multiple deaths close together there is no other path than the one through all the losses.

The deaths experienced by substance users can stack up like dominoes. It’s not just the number of deaths from drug use or by overdose but the vulnerability of the lifestyle can increase risk of death by other means (disease, infection, accident, homicide, suicide). And grief increases the risk for relapse or addiction and can create a full circle (Skolnick, 1979).

Type of Relationship

The type of relationship with the deceased affects grief too. Mother? Child? Using Friend? Friend who used to use and has been sober? Abusive ex-lover or an enabling partner? The relationship with the deceased at the time of their death, the relationship over time, and how close of a relationship it was can all affect grieving.

It’s a difficult death for the family of someone who died from substance use in a myriad of ways including suddenness, age of the deceased, and sense of being preventable. And it is a difficult and complicated loss for someone who used substances or was in recovery with the deceased. There is stigma, shame, shared blame and often just too much grief for someone.

Stigma and Disenfranchised Grief

Therese Rando wrote about “bereavement overload in the gay community” in her book Treatment of Complicated Grief in a discussion about how the AIDs epidemic affected those in the gay community. The lessons can be applied to the current grief epidemic in the substance use community. This community has experienced the loss of multiple members to a variety of reasons.  Members are sometimes blamed for the deaths of their using friends just by “being part of it.” The research regarding the grief after losing someone to AIDs shows how different these losses affect those community members left behind.

Treatment Suggestions

Those in the substance using community need focused grief treatment to learn ways to manage, process and make meaning out of their losses. How do we do this? With structured groups, unstructured grief support groups specifically for those who do or have used substances. There is a need for focused, individual grief counseling within substance use treatment and/or dual diagnosis treatment. And, there needs to be a way to publicly memorialize those this country has lost to substance use.

The National Safety Council has developed an interactive memorial website “Celebrating Lost Loved Ones” that memorializes those who have died from the opioid epidemic. The website enables one to click on an area of the country and view pictures and summaries of those who died from opioid use in that area. This is a wonderful example of a digital memorial for those lost to addiction.

Final Thoughts

In 2017 alone, the Center for Disease Control states that over 70,000 people from overdose of substances in the United States (CDC, 2019). Those 70,000 people were someone’s child, parent, sibling and friend. Those left behind are grieving and that grief reverberates throughout society in a multitude of ways including increasing the risk of health problems, exacerbation or institution of mental health issues, diminished work productivity which can increase risks of financial problems.  Grief will not resolve in a year, particularly when one is grieving multiple losses. Those who died are someone’s child, someone’s parent, someone’s friend and for those within the substance using community, the deaths are complicated by disenfranchisement, shame, blame and continued substance use.

Center for Disease Control (2019). Drug Overdose Deaths. Retrieved from: https://www.cdc.gov/drugoverdose/data/statedeaths.html. Last viewed: 12/1/19.

Mercer, D.L. and Evans, J.M. (2006) The Impact of Multiple Losses on the Grieving Process: An Exploratory Study. Journal of Loss and Trauma, 11:3, 219-227.

Rando, R.A. (1993) Treatment of Complicated Mourning. Champaign, IL:Research Press.

Skolnick, V. (1979) The Addictions as Pathological Mourning: An Attempt at Restitution of Early Losses. American Journal of Psychotherapy, 33:2, 281-290.

Grief Meets the Public

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I’ve heard “I don’t do funerals” from many clients over the years. It’s often a knee jerk reaction to avoid emotional pain, but some also will add: “I want to remember them alive, not see them like that.” 

Funerals and memorial services, like all rituals, serve a greater purpose. It’s not just about respect for the deceased, support for the family, or a societal obligation. Bereavement rituals like funerals and memorials have a place in the grieving process. The action of attending the ceremony with others can imbue a sense of community. There are others who also feel the loss.

Actively participating in bereavement rituals helps people move in the grieving process. It can help bring up the emotions that need to be experienced. I’m not saying that everyone needs to sob at a funeral or memorial, but avoiding feelings will often make the loss harder to manage. Certainly, numbing the feelings  with alcohol, substances or other avoidance behaviors can complicate grief. 

Memorials in public places are ways that some people express their grief and in some ways, they have almost come to replace the funeral as an American way of grieving. 

Shrines set up roadside, or next to a building or area (i.e., field, lake) where someone died are living memorials to loved ones lost. Roadside crosses, some simple, some decorated to express the personality or favorites of the deceased are on almost every road across the country. They give loved ones a place to mark the death and in some cases, celebrate the life that was ended at that spot. 

They have become so ubiquitous in American life that we forget there is a story with every marker. 

In Niagara Falls, NY a young man was killed while driving his motorcycle in the summer of 2019. The shrine started the day after the accident when several friends met in the grassy area next to the place where he died. Soon after, a large picture was erected and it was surrounded by remembrances and solar lights so that the memorial remains  illuminated throughout the night. 

Some shrines express the grief of a community; even a nation.  After the shooting at Columbine High School on April 20, 1999, a shrine was begun by friends, classmates and families of those who died in the massacre by piling their cars that remained in the parking lot with flowers, teddy bears, and other remembrances. The memorial spread to a nearby park where it grew and for weeks afterwards people came and walked through it to remember and mourn for those killed. 

That wasn’t the first public shrine and it wasn’t the last. The images of mass shootings have become the warp in the American fabric of life and the public shrines of mourning the weft. 

These have become one of the main ways we grieve as a society. 

Organizations have grieving rituals as well. The lowering of the flag to half-mast is an official expression of grief. The custodian at my children’s elementary school did the honor of raising to full mast and then lowering when it was called for. It was a solemn expression for him, even when he didn’t know who it was for. 

The half-mast flag is a well-known, institutionalized marker of grief. Organizations often develop their own unique ways to honor and memorialize a member of their community. 

If a University of Buffalo School of Social Work student dies before graduation, the school ties a white ribbon to an empty chair at their graduation ceremony in memory of the student. 

Cycling communities across the country have a tradition of leaving a white “ghost” bike as a marker of the death of a cyclist who died while riding. 


Memorials have gone digital as well. Facebook offers family members the ability to memorialize a person’s page after they have died. It enables people to continue to post images, memories and photos to the page. 

Video memorials that might have been created for a funeral often get posted to YouTube and remain a public memorial to a loved one. Meet Stacey Jayne Taylor who died from cancer in 2016. 

There is an active memorial group on Facebook called the “COUNTERfit Harm Reduction Program’s Drug Users Memorial Project.”  It “was established in 2010 as a remembrance, healing and community arts initiative to commemorate loved ones who have died in the War on Drugs.” The group sets up memorial events for people to honor and grieve those who have died from drug use. 

    This is a small handful of examples of public grieving. When you think about it, grief is everywhere in small and large symbols that run seamlessly through our daily lives. It affects you more when the roadside shrine you drive by every day is your loved one; or the ghost bike memorializes your friend. But it would help us all normalize and destigmatize expressions of emotions, especially related to grief, if we took a second to nod to that random shrine and wonder who the person was or who they left behind, or notice the flag at half-mast and think about the grieving friends and family, or the flowers woven into a chain link fence and smile at the love they represent. 

And the next time someone says, “I don’t do funerals” maybe give a little push back; offer to support them at the service and encourage them to find a way to express that love, pain and loss in some way.  

Grief Meets Stigma

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Grief is difficult enough when your relationship with your loved one was generally healthy, you had a chance to say goodbye, make amends, or just say ‘I love you’ one last time. The pain of it is overwhelming; at times, unmanageable. 

When you add stigma to the experience of grieving it makes makes it exponentially more difficult to manage. 

Stigma can simply be defined as being ‘othered,’ or viewed negatively by people, systems, or organizations and is manifested in overt behaviors or subtle language. The stigmatization can be formalized for example, only given two days of bereavement time after the death of a spouse or parent or terminated from a job. Or informally expressed in language used by those who might think they are being supportive. 

Stigmatization of grief often results in disenfranchised grief which proceeds hand-in-hand with complicated grief; known to increase symptoms of depression, mental health illnesses, alcohol and/or substance use, as well as impact physical health, ability to perform at work and overall life satisfaction. 

Grief can be a tsunami in someone’s life and if they do not feel that they can reach out for help from people, organizations or systems then that will almost always worsen the impact of grief. 

Stigmatization affects people inwardly and outwardly.  It can translate into the inability to attend funeral services or have acknowledgment of the importance of that person in your life. For example, one member of a gay couple dies and the family does not want it known that their child was gay so introduces the partner as a “friend” or ignores the partner completely. 

Or a child or sibling dies from a drug overdose the parents or family might blame the child’s partner for the overdose (particularly if both had a history of use). If the couple lived together in the deceased house/apartment the family might refuse to allow the partner to take any remembrance, or have any of the ashes (if they are cremated) or even have access to the home to retrieve their own possessions. They might take possession over animals that were shared. 

A partner in an affair who loses their lover but who cannot outwardly grieve. Cannot attend any of the services, and might have difficulty explaining to people why they are unable to be part of the communal rituals. 

Stigmatized grief, disenfranchised grief and complicated grief are all difficulties often endured by those who are addicted to substances or are working towards their recovery. The opioid epidemic has created a grief epidemic that is mostly born by stigmatized people. The addict, the substance user, the one struggling in their sobriety needs a space to grieve their losses. And in the opioid epidemic the losses continue to rise. 

If one person you cared about died every year for 5 years it would be overwhelming; almost impossible to recover from. Imagine if almost every death was stigmatized — they were using drugs, opiates, heroin, fentanyl — ‘it was bound to happen.’ Imagine if every death was one you couldn’t share with family or friends because they would point to your own struggle with substances, maybe your own continued use of opiates. 

My goal is to give those struggling with addiction the safe place to talk about their grief and how it is affected by their addiction. In the next couple of months me and a colleague of mine will be starting a drop-in grief group in Niagara Falls, NY for those in addiction or in recovery from addiction in order to give them a safe and supportive space to process their grief. 

Grief Meets the Village

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It takes a village to do just about anything. To raise a child. To move. To deal with the death of a loved one. To defeat addiction. 

Oftentimes those villagers are other people who are in the same boat, so to speak. They are also struggling with substance use, the death of a loved one, or in the trenches with a toddler who loves the word no. 

But sometimes, those villagers need to be professionals. Sometimes we need a village of professionals to help that person defeat their addiction, or grieve a loved one. 

Here’s a little story to set the scene for our village. 

Let’s say that Tonya and Jake are in love. Both are in recovery. Jake has almost a year sober from opioids; Tonya has a year and a half from the same. They are both working good jobs and have bright futures. They go to treatment or NA meetings regularly. They have supportive and sober friends and family members. They want to get married. They want to have a family. Both have lost friends to this addiction and vow to never touch opioids again. 

But then, Tonya relapses. Jake finds her in the apartment they’ve just begun to share. She’s overdosed and no one was with her to revive her. They had Narcan in the apartment; on the refrigerator, in plain view. 

Jake is devastated and ends up using himself. He overdoses and is revived by a friend who has Narcan too. Tonya’s family, once loving now blames Jake. They won’t let him into the apartment to retrieve his things, they won’t let him have any memento of Tonya’s. There is a huge fight at the funeral and he leaves. **

**Composite case. All names/identifying information has been changed.

What professional villagers might be able to help Jake? Or what villagers are needed to help diffuse situations like this? Or, even, what professional villagers might be needed to prevent this from happening? 

Jake’s substance use team is on the front line (counselor, MAT provider, psychiatrist). They recognize Jake’s increased risk for relapse and overdose and get him into the clinic. But Jake needs to keep his job. He works late and can only get in once or twice a week. He tries to go to meetings. He needs different kinds of villagers to help him out. 

What does he need exactly? Our goal? Keep Jake alive. Help him grieve Tonya and eventually, when he’s able, move on in his life. 

If he had a recovery coach? Or a case manager who could check on him, meeting him out in the community? If he had a grief group to attend, one that specializes in losses from addiction when you are in addiction.  

Anyone is welcome in an open, general group, but is someone who struggles from substance use, who lost their friend, sister, lover, to overdose going to feel comfortable sharing there? Maybe? But how do you process the shame and fear and devastation of the loss when the others in the room might not know what it is to lose someone like that? 

Medical professions are other important people in this village. ER professionals see those struggling from substance use frequently. Could an overdose be an opportunity to check in with them? Not just stabilize their medical symptoms and send them back out.  What happened? Is anything going on in your life that might have led to the relapse or overdose? I’m not suggesting these are intentional overdoses (although some might be). I’m suggesting it’s an open door to check on the psychosocial well-being of someone in addiction. 

So how can these ODs be prevented to begin with? How many different kinds of villagers do we need? 

We sure need researchers to continue to answer the questions that might help guide treatment. We need sociologists, psychologists, and neurobiologists. We need technology inventors, computer scientists working in Big Data and artificial intelligence to develop technologies that will continue to help providers and clients do more with less. We need public relationships gurus who are willing to take on stigma and figure out a way to get rid of it. 

We need a way to help Tonya not relapse at all. But if she does, and what happened, happens, we need to figure out a way to help all of those touched by Tonya’s death, especially those who have addiction problems, continue to live. 

I’ll leave you with one other thought. What if Tonya had a child? We’d need a much bigger village both before she overdosed and after. 

Grief Meets Peer Support

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Peer support can be a foundation in the recovery process from substance use and in processing grief after the death of a loved one. In-person (Griefshare has a directory of local groups) and online grief groups (see last week’s blogt for a listing) can offer peer support. Those in addiction often rely on support groups like Alcoholic Anonymous (AA), Narcotics Anonymous (NA), Secular Organizations for Sobriety, Rational Recovery, among others, which are led by those in addiction for those in addiction. AA and NA usually recommend those in the program choose a sponsor who is a peer. 

I have yet to find something that combines the two: a grief group for those who are in addiction who have lost a loved one to addiction. 

Generally speaking, there is less stigma in the death of a loved one who died from cancer or a car accident than there is for those who died by unintentional overdose, or a heart attack after cocaine use, or cirrhosis of the liver from alcoholism. Whether the stigma is internal or external, it often exists. And I believe that stigma can prevent people from attending a general grief group. They aren’t sure what the reaction is going to be when they share to the group that they used with their friend/relative/significant other who died. How would someone react? Would they blame them? And if they already feel guilty and ashamed, will it be intensified? Will the group make the grief worse? 

And yet this population needs a place to process their grief as well as a place to share their happy memories. They need a safe place and support to talk it out. Just like all of us do. 

Some studies have shown a connection between grief and addiction, that grief can be a risk factor for use or relapse. Disenfranchised grief, complicated grief and traumatic grief are all forms that sometimes need outside help either in the form of peer support or counseling to reduce its effects. If there is no help or support for this population, does it increase relapse? Could it increase the chances of the griever overdosing and dying themselves? I do not know. So far, I have not been able to find studies that have looked at overdoses that could be connected to the death of a loved one by substance use. 

I’ve found a study that states community support does not positively affect outcomes in grief; and I’ve found the opposite outcome in another study. I have heard from people who attend grief groups say that grieving with others is helpful and takes a bit of the burden off it. They say it helps to share. I’ve heard others say it doesn’t help them; that hearing others sad stories just makes it harder for them. 

The combination of addiction and grief is a difficult one. In order to move through grief it takes the development of tolerance for sadness and emotional pain. And it takes time — a lot of time. Often, someone with a substance use addiction struggles with management of emotional pain. The drug numbs the pain instantly and sometimes they get used to numbing the pain. It makes it difficult to process grief. 

Now, add to that the overwhelming number of deaths related to drugs, and then add “typical deaths” (i.e., illness or accident). 

How does the person with a substance use problem process their grief unless it’s with others who are also struggling with the same issues. What about the girlfriend of the man who died by opiate OD, who is shunned by his family and they blame her for his death. Or the man who used together with his girlfriend and he woke up, but she did not. The man who was drunk by his mother’s bedside and left right before she died to drink some more. The woman who was high at her step-father’s funeral because she couldn’t handle it any other way. 

They are unlikely to walk into a general grief group and with such a disenfranchised grief, a group is one of the things they might need. 

Currently, me and a counselor I work with are working on setting up a drop in grief group for those who are struggling with addiction. I’m not sure what, if anything it will do, but it’s a drop in the bucket and we’ve got to start somewhere. 

Grief Meets Online Resources

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When a client shares with you that a loved one has died, it is difficult to slow yourself down, particularly if you focus on shorter, solution-focused or CBT-type therapy. What do we do to help ease the often overwhelming pain they are experiences? It’s hard to avoid handing out resources: local grief therapists, local grief groups, online groups, forums, Facebook groups, apps, YouTube videos, podcasts, websites, blogs, and classes.

I might have missed something — there is a lot out there. 

All of these resources can be categorized in multiple ways but one way is: active vs passive. Discussion forums, Facebook groups, classes, grief groups and therapists require, to some degree, interaction with others. Some apps are also active in that they offer individual or group chats. Podcasts, articles, blogs, and YouTube videos are all passive activities; you’re listening or reading what someone else wrote. 

This is pretty important to remember because some people need to communicate their grief to others in order to process it so might do better in a more active setting. Conversely, if your client isn’t ready to talk about it, passive resources might be better. 

Other ways to categorize grief resources is the type of loss (sudden, cancer, SIDs miscarriage, drug overdose, suicide, etc.) or who died (mother, father, child, spouse, pet, friend, etc.) These categories can be helpful. 

Many of the resources that are available speak to “typical” or “normal” grief. By this I mean someone who had a generally healthy relationship with the one who died. The client does not have any other significant mental health symptoms , significant drug or alcohol abuse, and has the cognitive ability to process and work through their grief. 

This is not to say that those with mental health symptoms, addiction issues, or are cognitively challenged don’t experience grief, only that many of the grief resources available seem to assume a “level of functioning” prior to the death. 

Discussion forums

Discussion forums are generally accessed through a web-site. Some will forward posts or notifications to your email when someone posts or replies to your post. Otherwise you log into the website and access the forum to post, read and reply to others. Usually they are grouped by topic or subject (might be grouped according to how your loved one died, or who died) so people are able to pick and choose where they want to engage. 
Also, it would be important to make sure the forum is moderated. This should cut down on inappropriate posts. 

Here are some websites that offer discussion forums:

Grief Healing

Beyond Blue 

Grief Angels (there were not many posts)

Facebook Groups

I counted 100 Facebook grief groups when I searched (I wonder if the FB search only shows you 100 and there are actually more). These range from open groups, closed groups (one has to request membership), moderated and non-moderated groups. Generally, the moderators are volunteers and so the level of supervision each group gets will vary. And like any group of people there will be some people who are helpful and supportive, and others who aren’t. If it is not moderated (or moderated well), there could be a lot of offtopic posts including sales pitches or other solicitations. 

IRL (in real life) Groups

Griefshare is a national organization that has groups in various locations. There is a search engine on the website where you can find local groups. The griefshare group is a focused and topical group and has a 13 week curriculum that repeats. Groups are monitored by peers. They also offer daily supportive emails. 

Some Hospice centers offer grief groups. Check with your local Hospice to see their offerings. If they do not run them, someone at the organization should be able to point you to any local grief groups. 


For some people, nothing beats sharing your pain with real people who understand. Groups can be very powerful. If someone is not internet-savvy, or might struggle to connect with people online for support, the IRL groups can be most beneficial. The downside is that they are subject to regular human difficulties: not enough interest or commitment, cancellation by leader due to illness or other life event, etc. 

In addition, it might be difficult for people to share in a group of others. Social anxiety can be overwhelming and the fear of judgment, or thoughts that their grief isn’t “worthy” could interfere with someone’s ability to get enough support. 

Apps

Generally most of the apps are free but subscribers should be on the look-out for in-app charges or if the app is free for a certain time period and then there is a charge. Also, apps can be buggy and develop glitches and they are only as good as their content developers and technical support. Apps are nice because they are generally always at your fingerpads and grief can be processed in bite-sized pieces. 

Lilies is an app for young grievers and send virtual hugs to users. 

Apart of Me and Nino’s Mourning are other apps specifically for children

Grief Support Network that connects with the online Grief Angels website which includes discussion boards. 

Goodgrief – is like OkCupid meets grief but without the dating. The app offers 1 on 1 matching to develop support between people who have had similar losses. There is a charge for this app; it is not free.  

Help for the Grieving is an app that is a Roman Catholic faith-based app

PetGrief247 is an app for those who are grieving the loss of a pet

MyStrength and Headspace are general mental health apps that also have sections dedicated to grief and loss information and coping skills. In addition, coping skills for depression and anxiety can be helpful to those who are grieving. 

YouTube is a great source of videos on grieving. TedTalks offers multiple videos (usually in about 20 minute chunks) of information, solace and inspiration. Anderson Cooper, a CNN news anchor has conversations with both Stephen Colbert and Liam Nielson about their grief experiences that are wonderful. I’m not sure it would be helpful to someone who is in the early throes of grief as both spoke of enduring grief over the years and how it changed them.

There are how-to videos as well, including meditation and specific techniques. 

This video discusses the practical aspects of what happens to the brain when someone is grieving.

You can find short videos, long videos, conference presentations, interviews, Oprah talks and more. 

Here is a conference presentation by John R. Jordan, PhD. who specializes in helping suicide loss survivors.

Podcasts

Podcasts can be downloaded to a phone or device and listened to in the car, on a walk, or wherever. Podcasts are interesting ways to talk about grief and don’t generally come with a set of instructions or list of coping mechanisms. They are often real people talking about the impact of death and grief on their life. 

What’s Your Grief (also a website that offers webinars and ecourses in grief, in addition to having an excellent blog). 

Who Died? Is a newer podcast which features an interview with someone who tells of the life and death of their loved one. For someone who loves to hear poignant stories of life and dying, this is a wonderful podcast. This might be a struggle for someone in the early days of grief; or might just be what helps. Like all of the resources suggested here: it just depends. 

Grief Out Loud is a podcast sponsored by The Dougy Center which discusses many different aspects of grieving and how it has affected people. 

Mindfulness and Grief is a podcast that attempts to do just what its title states. Through interviews with various practitioners It discusses how to imbue mindfulness into the grieving process. 

Grief is a Sneaky B!tch is hosted by Lise Keefauver a social worker and widow. Again, deep conversations with different people who share their stories and their experiences with death and grief. 

Websites and Blogs

Sudden Death offers information and support for those who have lost someone suddenly

What’s Your Grief (so good it bears a second link)

Refuge in Grief offers a writing course that is supportive and therapeutic. Writing prompts are given each week to help one work through different aspects of grief. She also put together this cute animated video that gives advice on how to help those who are grieving.

Diary of a Widower is a blog that was written by a man whose wife died and left him with two small children. It is no longer kept up, but the archives could certainly be helpful to widowers. 

Still Standing Magazine is a website that offers support and information to those grieving the death of a child or experiencing infertility

Tragedy Assistance for Survivors offers supports and resources for those who have lost loved ones in the U.S. Armed Services. 

Bereaved Parents offers support to parents, grandparents or siblings. 

Please Note: In listing these resources I am not able to verify and am not responsible for any of their offered services, hours of operation, claims/suggestions/resources/or if there are any costs involved, or effectiveness. Grief is a unique journey for everyone. What works for you might not work for someone else and in most cases, we all have to find our own path to take through it.   

Grief Meets Facebook

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My mother died in 2011 and every year, on the anniversary of her death I would post a picture of her and write a memorial on Facebook. It helped me grieve, year after year, being able to tell the story of her death and share parts of her life with my friends. And every year, people would comment words of support and add their memories to my post. 

It never occurred to me that Facebook was collecting information about me and my friends through that post. 

Photo by Mario Purisic

Grieving for a loved one should be able to be carried out in a sacred, safe space. Big Brother, or rather, Big Data, shouldn’t interfere with it, but for the millions who express and process their grief on social media, underneath it all, data continues to be collected and expressed through the algorithms used by social media platforms. 

Ever google something on your computer and then every time you open your Facebook account there is an ad for whatever you searched for? Or something similar? It’s disconcerting at best, and to many people, it feels invasive. 

Since the beginning of Facebook there have been issues with privacy and this article from NBC sets out an interesting timeline. 

https://www.nbcnews.com/tech/social-media/timeline-facebook-s-privacy-issues-its-responses-n859651

So what’s a Facebook griever to do? There are many grief discussion forums (check back next week for a listing of online grief resources) where you can connect with others who are similarly grieving, but the discussion boards don’t have the same convenience, interactibility and, well, ubiquitousness like Facebook does (you can check your grief group postings and wish your non-grieving friend happy birthday all in the same place). It’s an easy app on your phone or tablet and has all those features we love — remembers you every time you log in, sorts your feed for you so you see things that interest you. . .  

Oh, wait a minute. 

That’s right. Big Data likes your information and wants to help you. Whether you want that help or not. 

Is there such a thing as too much grieving? What if you are searching for places to process your grief, find a local grief group, and find a grief counselor. You’re googling all these things and we know how much Facebook and Google like each other. Is it possible that your feed could become too sad? Filled with too much grieving? 

Everyone’s grief journey is different but an interesting grief theory called Dual Processing Model talks about how it’s important to spend time grieving and equally important to spend time doing other things. In the beginning, after your loved one dies, “other things” might consist of showering, eating, and distracting yourself with cute animal videos. Later on it might be reading articles about politics (well, maybe not), playing games, or spending time with friends and family.  The trick is, you don’t want to completely avoid grieving, and you also don’t want to grieve at the expense of life. It’s trying to find the right spot for you at the time you are in. Could Big Data and Facebook algorithms interfere with that? It’s possible. 

Is there a solution? The simplest solution to avoiding all of your Facebook data being collected and used to, uh, help you, is to delete your Facebook account. That will prevent any future data being collected and mined for information, but it doesn’t get rid of the data they have already collected. 

At the risk of sounding like Facebook is an awful place to be, I do think one of the wonderful things about it is that they have enabled it so a person’s page can continue as a memorial space after they die. People can leave messages, pictures and communicate with others in ways that are supportive to the grievers. Grieving in a community (online and/or IRL) is one of the most helpful ways to traverse the grief path. Online spaces like Facebook provide a space for that kind of community that can be incredibly helpful. 

#griefepidemic

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The fact that there is an opioid epidemic in the U.S. is not news. However, the grief epidemic that reverberates like aftershocks from an earthquake does not get much attention. 

Should it? 

The Center for Disease Control reports that over 702,000 people died in the U.S. from drug overdoses between the years 1999 and 2017. In 2017 alone, the estimate is 70,000 people died from overdoses of substances. 

Let’s assume an average of 5 people were significantly impacted by the death of each of those who died in 2017. That is approximately 350,000 that have been affected by those overdose deaths. 

That is a grief epidemic. 

Photo credit: Sydney Angove

Grief isn’t just about funerals, cemeteries, tears and sadness. Grief can negatively impact physical health, mental health, work productivity,and  relationships. 

Also, there is some research that supports the theory that experiencing grief increases the risk of addiction or relapse and while the understandable focus has been on how to stop the deaths, maybe we also need to provide assistance for this specialized grief both individually and as a community at large. 

I’ve tried to find some other historical phenomenon or event that is similar to this one. The only thing I can think of is the AIDs epidemic or war. The sheer number of deaths and the devastation on those left behind. 

Would a national memorial project similar to the AIDs Quilt Project help? Would it give people a public arena to express their grief? 

At this point in time I have more questions than answers. Do we make a grief group part of regular substance use treatment? If we did, what would it look like? If someone does not want to grieve in a traditional way, how can we encourage someone to do that, knowing that it helps so many others. 

What about the children? The highest rates of deaths from opiate overdose are between the ages of 25 and 54. I don’t have a source to support it but wouldn’t that be prime child-raising years? How many children have been left behind to grieve their mother or father from overdose? How will that affect them over the course of their life? 

So many questions… 

Grief Meets Misconceptions

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My 15 year old cousin Marie died in a car accident in 1977 and my aunt, now 92 continues to grieve her every single day. I remain impressed that she gets out of bed, has a lively sense of humor, and continue to love life. 

About five years after Marie’s death my aunt was going to the cemetery and she paused to say hello to her neighbor. The neighbor asked, “How are you?”

My aunt replied: “Not good at all. Today is Marie’s birthday.”

The neighbor: “Aren’t you over that yet? How long has it been?”

I’m not quite sure what my aunt said. She is a polite woman who was probably too shocked and in pain to say anything. 

My aunt’s other ‘favorite’ was: “God only gives you as much as you can handle.”  Her succinct reply is: “He’s wrong, I can’t handle this.” 

I think one of the biggest misconceptions about grief is that it ends; that you should work towards closure, moving on, or getting over it. That rarely happens.

When someone who you love or care about dies you’re given a weight. In the beginning that weight feels so heavy. You drop it a lot, stumble over it, sometimes you need others to help you carry it. As time goes by, you develop grief muscles. It gets easier to carry but it never goes away. 

There are a lot of grief theories out there. There are stages (originally based on the stages of dying but reworked for grief), there are tasks, there are processes. There are theories about complicated grief, traumatic grief and distorted grief (and that’s not the entire list). 

And in the end, it seems that what is an elemental and ubiquitous human experience is almost impossible to generalize. What worked for my aunt might not work for someone else. It might help someone to hear that God only gives them as much as they can handle. It might help them dig into their faith more and use it to help them get through the grief. 

Another misconception is about denial and some feel that denial is a stage, and it can be. However, denial is better explained as a defense mechanism and it is an understandable one. Most don’t want to believe that their loved one is really gone.  

Denial is elusive and hard to spot. Someone might say “of course I know they are dead” but actually might speak in other ways and exhibit behaviors that illustrate the denial is there and it is making it difficult for them to process their grief. 

You shouldn’t force the abandonment of denial. It is protective sometimes and needs to be managed gently. Of course a parent doesn’t want to say that their child is dead and buried in a cemetery or their ashes are scattered at a lake. They want to pretend they are on a trip, or will be back soon. It’s understandable and needs to be challenged very gently (if at all). 

Like everything in grief, it takes time. 

The year of grief is another misconception. Grief does not have a time table. Some say the second year is actually harder than the first. Others can resolve the most intense phase of grief within a year and feel better after that first anniversary. It all depends on the person, their mental health, ability to regulate their emotions, their support system, the relationship they had with the deceased; I could keep going. 

It just depends. 

Grief Meets Technology

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You might not think that grief and technology would be a good fit but there are many digital options to help those who are grieving. You don’t need complicated equipment (although there are options for those interested in grieving with virtual reality). Facebook, your favorite app store, or the old fashioned internet can find you a place to connect with others in your grief. 

There can be comfort in community and technology can connect you with a general or specific community. If you are the parent of a child who died by suicide, or drug overdose, or brain cancer, you can find a digital group that will consist of others in your situation. That is the beauty of digital spaces; you don’t have to go to be in the same zip code, or even the same time zone. 

Facebook offers easy to join groups and the platform is simple to use if you’re already on the social media site. A search of grief support group reveals pages and pages of support groups available. This is a positive, and a negative. Often, especially in the early days and weeks of grief, trying to figure out anything, even the most mundane tasks takes much more time than it did before. Trying to wade through all of the choices and find the one right for you might take some trial and error. As in all things grief, be gentle to yourself.

Photo by Hammer & Tuck

If you’re not on social media, you can search through your app store for grief apps. There are less apps than Facebook groups, for sure, but there are options that can connect you with local grief groups, or online chat groups. There is the Grief Support Network, Good Grief, Grief Loss among others. 

Another way that many people grieve online, that does not include groups or even other people, is memorial pages on Facebook. After someone dies, their page can be maintained and it enables friends and loved ones to leave messages and connect with others. 

Whatsyourgrief.com is an excellent website that has a well-written blog, Facebook group, online courses, and webinars. The authors tackle a variety of subjects related to grief. They also host a podcast in case you can’t, or don’t want to spend time reading. 

An interesting way to connect with others in online spaces is through virtual reality.In an article in Medical Daily, a person described how moving it was to attend a VR grief group. She told how she was able to cry in the safety of her own home while listening to others share their grief but her avatar did not show any emotion. The literal space between her feelings and the others increased her comfort level and she felt safe enough to cry. This is just one way that virtual reality might be able to help those grieving. 

Virtual reality has been shown to be helpful in exposure therapy and in certain circumstances, grief can include things like exposure to certain places or things that increase feelings of grief. Using VR could improve a person’s coping. 

In the end, grief is a unique experience for each person. Digital spaces might help a person grieve; or they may not. It is just another tool to use when and if you want to.